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Postoperative delirium following cardiac surgery: the incidence, risk factors and outcome
Journal of Cardiothoracic Surgery volume 10, Article number: A298 (2015)
Postoperative delirium (POD) is a common and serious complication after cardiac surgery and numerous studies have confirmed this in occurrence from 10% to 60%, patients have an increased risk of developing POD that is associated with poor outcomes.
The aim of this study was to identify POD incidence, potential risk factors and to evaluate clinical outcome.
A single-centre cohort of 292 patients undergoing elective cardiac surgery were prospectively enrolled.
The incidence of POD was 27.74%. The analysis showed that POD prolonged the length of the ICU stay 5.8 (± 2.89) vs 3.86 (± 1.91) days, p < 0.001, patients after POD more frequent was required re-intubation (OR: 13.169; 95% CI 1.456-119.087, p = 0.022) and had had the prolonged length of the postoperative hospital stay >10 days (OR: 2.060; 95% CI 1.226-3.460, p = 0.006). Multivariate analysis remained as an independent predictors for POD: age > 70 yr (OR: 2.227; 95% CI 1.325-3.742, p = 0.003), ejection fraction < 42% (OR: 2.398; 95% CI 1.397-4.117, p = 0.002), length of stay in the hospital before surgery > 6 days (OR: 1.840; 95% CI 1.064-3.180, p = 0.029), combined valve repair and CABG surgery (OR: 2.083; 95% CI 1.153-3.761, p = 0.015), duration of CPB > 86 min (OR: 2.068; 95% CI 1.182-3.618, p = 0.009) and postoperative atrial fibrillation (OR: 2.244; 95% CI 1.158-4.347, p = 0.007).
Our current analysis suggests that POD is a frequent complication and worsen patient outcome following cardiac surgery. Many factors cannot be changed or avoided but some can be modified and it depends from us: if to shorten the length of stay in the hospital before surgery < 6 days, it may reduce the number of patients who develop POD. By the way, a large prospective randomised study in this regard is needed.
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Andrejaitiene, J., Benetis, R. & Sirvinskas, E. Postoperative delirium following cardiac surgery: the incidence, risk factors and outcome. J Cardiothorac Surg 10, A298 (2015). https://doi.org/10.1186/1749-8090-10-S1-A298
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